Active NPI
Samuel C Carpenter, DPM
- Podiatrist
- Farmington, NM
National Provider Identifier
1528172871
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Podiatrist
- License
- 171
- Practice address
- 304 S Lake St
Ste 104
Farmington, NM 87401-5659 - Phone
- (505) 327-3338
- Fax
- (505) 566-9213
- NPI assigned
- Aug 17, 2006
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Podiatrist | 213E00000X | 171 | NM | Primary |
Addresses
Primary practice location
304 S Lake St
Ste 104
Farmington, NM 87401-5659
Mailing address
304 S Lake St
Ste 104
Farmington, NM 87401-5659
Phone (505) 327-3338
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 55640 | Medicaid | NM |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 171 | NM | MD | Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1155772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1397347200000",
"number": "1528172871",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "304 S LAKE ST",
"address_2": "STE 104",
"city": "FARMINGTON",
"state": "NM",
"postal_code": "874015659",
"telephone_number": "505-327-3338",
"fax_number": "505-566-9213"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "304 S LAKE ST",
"address_2": "STE 104",
"city": "FARMINGTON",
"state": "NM",
"postal_code": "874015659",
"telephone_number": "505-327-3338",
"fax_number": "505-566-9213"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARPENTER",
"first_name": "SAMUEL",
"middle_name": "C",
"name_prefix": "Dr.",
"credential": "DPM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-08-17",
"last_updated": "2014-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "213E00000X",
"taxonomy_group": "",
"desc": "Podiatrist",
"state": "NM",
"license": "171",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "55640",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}Other providers in Farmington, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.